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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 C3 ,3_O'7 <br />/) 42b-257-8810 - FAX 425-257-8857 — www.everettWo.org t~O�O�— O it <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Owner Men Addrese <br />city <br />Tenant Mod Addrms <br />City <br />FJerFrIr t, , 3115 5-91"', <br />OE <br />.16dril,I ontrador Men Addreas <br />CRY <br />Stab LlCenae Numbor <br />Prop _y&ftdfBu,1dAg <br />NOTE: WIRING IN NUN-DNELLINOS IS REQUIRED TO <br />BE IN RACE"AVS, MC OR AC CABLE <br />Slete2lp <br />6tate2lp <br />Phone <br />✓ Stsi Panne <br />C/-;, � --- <br />Price of Warit <br />Contact Person (Pun Revlew) <br />CITY OF EVERETT LOCAL SALES TAX CONE 18 2106 <br />I hereby cort that I have head and avem/ned this applicallon and know the some to he Mrs end <br />correct All prhvislons ollews and ordinances pnwrmingg this type of work WN De Completed <br />whether specMad horeln or not. The granting of a perm7f dose" presume tp giye euthomy lo <br />pviollayt�offor neencel the provisbns of an other state or local law re(guulatinp consliud/on or IN. <br />work IoravhMh a pticla ion iss Theft enrol comply with the Slate Conk his ore w 18.27'RC e' d <br />2 0.2f>0 WAC. <br />I -A? 9 <br />rFEE <br />L_ <br />e pgpy- o) 1 <br />ZCIO 0 3IN.LJn3 914I9IA TVA ZT:OT 60OZrZOr60 <br />